TY - JOUR
T1 - Late-phase human herpesvirus 6B reactivation in hematopoietic stem cell transplant recipients
AU - Miura, Hiroki
AU - Kawamura, Yoshiki
AU - Hattori, Fumihiko
AU - Tanaka, Makito
AU - Kudo, Kazuko
AU - Ihira, Masaru
AU - Yatsuya, Hiroshi
AU - Takahashi, Yoshiyuki
AU - Kojima, Seiji
AU - Yoshikawa, Tetsushi
N1 - Publisher Copyright:
© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
PY - 2018/8
Y1 - 2018/8
N2 - Background: We sought to determine whether late-phase human herpesvirus 6B (HHV-6B) infection in hematopoietic stem cell transplant (HSCT) recipients was associated with serious outcomes and mortality. Methods: The occurrence and course of HHV-6B infection was monitored for at least 60 days after transplant using virus isolation and real-time polymerase chain reaction. Risk factors for late-phase HHV-6B infection were examined, and the propensity score was calculated with significant risk factors. The inverse probability-weighted multivariable logistic regression analysis was performed to estimate odds ratios (ORs) and the 95% confidence intervals (95% CI) for mortality. Results: Late-phase HHV-6B infection was observed in 12/89 (13.5%) of the HSCT recipients. Older age (OR: 10.3, 95% CI: 2.1/72.9, P =.0027), hematologic malignancy (OR: 10.3, 95% CI: 1.8/97.1, P =.0063), unrelated donor transplantation (OR: 5.3, 95% CI: 1.1/36.0, P =.0345), and sex-mismatched donor transplantation (OR: 6.3, 95% CI: 1.4/39.5, P =.0149) were identified as risk factors for late-phase HHV-6B infection. Fifteen subjects died (17%). Inverse probability-weighted multivariable logistic model analysis revealed that late-phase HHV-6B infection was an independent risk factor for mortality (OR: 4.2, 95% CI: 1.7/11.0, P =.0012). Among 5 of the fatal cases of late-phase HHV-6B infection, viral infection might be associated with severe clinical manifestations. Conclusion: Late-phase HHV-6B infection in HSCT recipients was associated with worse outcomes. The full spectrum of clinical features of the infection has not been fully elucidated, and therefore, recipients with high-risk factors for late-phase HHV-6B infection should be carefully monitored.
AB - Background: We sought to determine whether late-phase human herpesvirus 6B (HHV-6B) infection in hematopoietic stem cell transplant (HSCT) recipients was associated with serious outcomes and mortality. Methods: The occurrence and course of HHV-6B infection was monitored for at least 60 days after transplant using virus isolation and real-time polymerase chain reaction. Risk factors for late-phase HHV-6B infection were examined, and the propensity score was calculated with significant risk factors. The inverse probability-weighted multivariable logistic regression analysis was performed to estimate odds ratios (ORs) and the 95% confidence intervals (95% CI) for mortality. Results: Late-phase HHV-6B infection was observed in 12/89 (13.5%) of the HSCT recipients. Older age (OR: 10.3, 95% CI: 2.1/72.9, P =.0027), hematologic malignancy (OR: 10.3, 95% CI: 1.8/97.1, P =.0063), unrelated donor transplantation (OR: 5.3, 95% CI: 1.1/36.0, P =.0345), and sex-mismatched donor transplantation (OR: 6.3, 95% CI: 1.4/39.5, P =.0149) were identified as risk factors for late-phase HHV-6B infection. Fifteen subjects died (17%). Inverse probability-weighted multivariable logistic model analysis revealed that late-phase HHV-6B infection was an independent risk factor for mortality (OR: 4.2, 95% CI: 1.7/11.0, P =.0012). Among 5 of the fatal cases of late-phase HHV-6B infection, viral infection might be associated with severe clinical manifestations. Conclusion: Late-phase HHV-6B infection in HSCT recipients was associated with worse outcomes. The full spectrum of clinical features of the infection has not been fully elucidated, and therefore, recipients with high-risk factors for late-phase HHV-6B infection should be carefully monitored.
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U2 - 10.1111/tid.12916
DO - 10.1111/tid.12916
M3 - Article
C2 - 29797616
AN - SCOPUS:85052793757
SN - 1398-2273
VL - 20
JO - Transplant Infectious Disease
JF - Transplant Infectious Disease
IS - 4
M1 - e12916
ER -